For years, Dr. Ignacio Ponseti, a world-renowned expert in the treatment and management of clubfeet, has advocated use of a foot and ankle abduction orthosis (AFO) to prevent relapses of the deformity after the clubfoot is corrected. Such a device consists of a bar of about the length between the baby's shoulders with high top open-toed shoes attached at the end of the bar in about 60 degrees of outward rotation. The splint is worn full time for two to three months, and thereafter at night and naptime for 2 to 4 years. Corrective adjustments to the foot alignment are often necessary.
For many years, Dr. Ponseti used, with great success, the well-designed round-heeled high-top commercial shoes made by Penney's with soft leather. These are no longer available, and companies supplying much of the industry today don't produce adequate shoes attached to the bar. They often cause pressure sores and blisters on the baby's tender feet. Short and chubby clubfeet, even when well corrected, slip inside the shoe and even out of it, causing sores, loss of correction, great discomfort to the child and anguish to the parents.
Another problem is that it is often difficult to properly put the shoes on the patient's feet. In some instances, parents try to put the child's feet in the shoes while the shoes remain attached to the Denis Browne splint. It is not only difficult for the parent, but uncomfortable for the child. Others have proposed shoes which have a simple latch mechanism which is attached to the sole of the shoe. Such a combination allows the parent to put the shoes on the child first and then latch the shoes to the Denis Browne splint. These mechanisms attached to the bottom of the shoe are not only unsightly, but they are clumsy for the child to handle.
Consequently, there is an urgent need for improved methods and systems that will prevent relapses and sores while allowing free knee and ankle motion necessary to develop leg muscle strength.